Evidence from Low and Middle Income Countries
Embracing Diversity: Toolkit for Creating Inclusive, Learning-Friendly Environments Specialized Booklet 3
Transforming Health: Accelerating attainment of Health Goals | THE SECOND MEDIUM TERM PLAN FOR HEALTH
La réanimation a pour objectifs de prévenir et de pallier les différentes défaillances
viscérales aiguës. Elle s’adresse aux malades graves et est actuellement considérée
comme un élément normal de l’arsenal thérapeutique. Les médecins et les soignants ont
démontré l’utilité ...de la présence permanente 24 heures/24 et 7 jours/7 auprès des
malades graves d’une équipe hautement spécialisée. Ensemble, ils ont fait progresser les
techniques nécessaires à la prise en charge de ces malades : ventilation mécanique,
épuration extrarénale, surveillance et exploration cardiovasculaires... La réanimation
médicale née sur le terrain hospitalier a obtenu sa reconnaissance universitaire en 1969.
Le champ d’application de la réanimation s’étend à toute la pathologie et en particulier aux malades chirurgicaux. La distinction entre réanimation médicale et réanimation chirurgicale a été nécessaire pour une répartition raisonnable des tâches, surtout en
CHU, et aucunement en raison de connaissances pratiques et théoriques différentes. Cette distinction est obsolète, car il n’y a pas plusieurs façons de faire de la réanimation.
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Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the
South of the United States. It is an important cause of early mortality and morbidity, and it is associated with poverty and stigma. A third of
the cases evolve into chronic... cardiomyopathy and gastrointestinal disease. The infection is transmitted vertically and by blood/organ
donation and can reactivate with immunosuppression. Case identification requires awareness and screening programmes targeting the
population at risk (women in reproductive age, donors, immunocompromised patients). Treatment with benznidazole or nifurtimox is most
effective in the acute phase and prevents progression to chronic phase when given to children. Treating women antenatally reduces but does
not eliminate vertical transmission. Treatment is poorly tolerated, contraindicated during pregnancy, and has little effect modifying the
disease in the chronic phase. Screening is easily performed with serology. Migration has brought the disease outside of the endemic
countries, where the transmission continues vertically and via blood and tissue/organ donations. There are more than 32 million migrants
from Latin America living in non-endemic countries. However, the infection is massively underdiagnosed in this setting due to the lack of
awareness by patients, health authorities and professionals. Blood and tissue donation screening policies have significantly reduced
transmission in endemic countries but are not universally established in the non-endemic setting. Antenatal screening is not commonly
done. Other challenges include difficulties accessing and retaining patients in the healthcare system and lack of specific funding for the
interventions. Any strategy must be accompanied by education and awareness campaigns directed to patients, professionals and policy
makers. The involvement of patients and their communities is central and key for success and must be sought early and actively. This review
proposes strategies to address challenges faced by non-endemic countries
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Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses to address the many outstanding resea...rch questions. This systematic review aims to describe the characteristics and treatment practices of clinical studies in CD and assess the breadth and availability of research data for the potential establishment of a data-sharing platform.
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PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop...le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
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Nature Medicine, https://doi.org/10.1038/s41591-021-01283-z